Osteosynthesis plates for stabilization of bone fractures typically are applied with bone screws. Traditionally, bone screws compress a plate onto the bone surface to provide stable fixation. More recently, locking plates have been introduced, which typically have threaded receiving holes for positive, angle-stable fixation of locking screws that have a correspondingly threaded screw head. These locked plating constructs can provide more durable fixation than traditional non-locked constructs, particularly in weak osteoporotic bone.
However, the inherent stiffness of locked plating constructs causes two clinical challenges. First, it may alter the load distribution in bone, which may either cause bone resorption in load-shielded regions adjacent to the plate, or bone fracture due to implant-induced stress risers. Second, the high stiffness of an osteosynthesis plate construct suppresses relative displacement between bone fragments; however, such interfragmentary motion is important to promote the natural cascade of fracture healing by callus formation. Therefore, overly stiff locking plate constructs may delay or prevent fracture healing, which may also lead to implant breakage or loss of screw fixation in the bone.
Overview
To better illustrate the bone plates disclosed herein, a non-limiting list of examples is provided here:
In Example 1, a device can be provided that includes a bone plate having an upper surface and a bone-facing surface, the bone plate comprising one or more openings extending through the bone plate from the upper surface to the bone-facing surface. The device can further include one or more sliding elements, each sliding element including a fastener receiving hole, wherein the one or more openings at least partially surround a periphery of one of the receiving holes, and wherein the one or more openings are at least partially filled with an elastomer to support elastic suspension of the one or more sliding elements in the bone plate, thereby enabling relative displacement between the one or more sliding elements and the bone plate. The device can further include at least one sensor operable to assess a dynamic parameter of one of the one or more sliding elements within the bone plate.
In Example 2, the device of Example 1 is optionally configured such that the sensor is operable to track a relative position of the sliding element relative to the bone plate.
In Example 3, the device of any one of or any combination of Examples 1-2 is optionally configured such that the sensor is operable to measure displacement of the sliding element relative to the bone plate.
In Example 4, the device of any one of or any combination of Examples 1-3 is optionally configured such that the sensor is operable to measure pressure within the elastomer that is suspending the sliding element in the bone plate.
In Example 5, the device of any one of or any combination of Examples 1-4 is optionally configured such that the sensor is positioned at least partially within the elastomer.
In Example 6, the device of any one of or any combination of Examples 1-5 is optionally configured such that the sensor is operable to measure pressure applied to the bone plate by the elastomer that is suspending the sliding element in the bone plate.
In Example 7, the device of any one of or any combination of Examples 1-6 is optionally configured such that the sensor is self-powered.
In Example 8, the device of any one of or any combination of Examples 1-6 is optionally configured such that the sensor is powered by an external power source.
In Example 9, a bone plate can be provided that includes a plate body having an upper surface and a bone-facing surface, a plurality of openings extending through the plate body from the upper surface to the bone-facing surface, one or more sliding elements each including a fastener receiving hole, each of the one or more sliding elements positioned within a different one of the openings such that the opening at least partially surrounds a periphery of the receiving hole, an elastomer layer at least partially surrounding each of the one or more sliding elements, thereby enabling relative displacement of the sliding element within the plate body, and one or more sensors operable to assess a dynamic parameter of the one or more sliding elements within the plate body.
In Example 10, the bone plate of Example 9 is optionally configured such that each receiving hole is a threaded receiving hole.
In Example 11, the bone plate of any one of or any combination of Examples 9-10 is optionally configured such that each receiving hole is cylindrical.
In Example 12, the bone plate of any one of or any combination of Examples 9-11 is optionally configured such that the elastomer layer has a modulus of elasticity in the range of 0.1-50 MPa.
In Example 13, the bone plate of any one of or any combination of Examples 9-12 is optionally configured such that the elastomer layer is silicone.
In Example 14, the bone plate of any one of or any combination of Examples 9-13 is optionally configured such that the one or more sensors are operable to measure displacement, pressure, or load to capture a presence or magnitude of load transfer between the sensor and the plate body as a means for estimating the progression of fracture healing.
In Example 15, the bone plate of any one of or any combination of Examples 9-14 is optionally configured such that at least one elastomer layer includes an energy generation element to supply transient power to the one or more sensors.
In Example 16, the bone plate of any one of or any combination of Examples 9-14 is optionally configured such that the one or more sensors are powered by an external power source.
In Example 17, the bone plate of any one of or any combination of Examples 9-16 is optionally configured to include one or more accelerometers to determine acceleration of the plate body or one or more of the sliding elements.
In Example 18, the bone plate of Example 17 is optionally configured to include a first accelerometer operably coupled to the plate body and a second accelerometer operably coupled to one of the sliding elements.
In Example 19, the bone plate of Example 18 is optionally configured such that the first and second accelerometers provide feedback to determine a relative acceleration of the sliding element with respect to the plate body.
In Example 20, a device can be provided that includes a bone plate having an upper surface and a bone-facing surface, the bone plate comprising one or more openings extending through the bone plate from the upper surface to the bone-facing surface. The device can further include one or more sliding elements, each sliding element including a fastener receiving hole, wherein the one or more openings at least partially surround a periphery of one of the receiving holes, and wherein the one or more openings are at least partially filled with an elastomer to support elastic suspension of the one or more sliding elements in the bone plate, thereby enabling relative displacement between the one or more sliding elements and the bone plate. The device can further include at least one sensor operable to measure at least one of displacement, pressure, or load to capture a presence or magnitude of load transfer between the sensor and the bone plate and to estimate the progression of fracture healing.
In Example 21, the device or bone plate of any one of or any combination of Examples 1-20 is optionally configured such that all elements or options recited are available to use or select from.